Anxiety Disorders

Anxiety•Anxiety – general state of dread or uneasiness that occurs in response to a vague or imagined danger.•Puts us on physical & mental alert, preparing us to defensively “fight” or “flee” potential dangers, •Behaviors include – nervousness, inability to relax, concern about losing control, trembling, sweating, rapid heart rate, shortness of breath, high blood pressure, light-headedness.

When is Anxiety a Problem?• In the anxiety disorders, the anxiety is

maladaptive, disrupting everyday activities, moods, and thought processes

• Three features distinguish normal anxiety from pathological anxiety. Anxiety is a problem when it is:

1. Irrational—it is provoked by perceived threats that are exaggerated or nonexistent, and the anxiety response is out of proportion to the actual importance of the situation.

2. Uncontrollable—the alarm reaction cannot be shut off even when the person knows it’s unrealistic.

3. Disruptive—it interferes with relationships, job or academic performance, or everyday activities

Phobia

Phobia

• An anxiety disorder characterized by disruptive, irrational fears of specific objects or situations

• The fear must be both irrational and disruptive and cause avoidance behaviors.

• About 10 percent of the general population will experience a specific phobia at some point in their lives.

PhobiasGenerally, the objects or situations that

produce specific phobias tend to fall into four categories

1. Natural environment—heights, water, lightening

2. Situation—flying, tunnels, crowds, social gathering

3. Injury—needles, blood, dentist, doctor4. Animals or insects—insects, snakes, bats, dogs

Development of Phobias

• Preparedness theory—phobia serves to enhance survival. – Humans seem biologically

prepared to acquire fears of certain animals and situations that were survival threats in human evolutionary history

Social Phobias

• Social phobias—fear of failing or being embarrassed in public– public speaking (stage fright)– fear of crowds, strangers– meeting new people– eating in public

• Considered phobic if these fears interfere with normal behavior

• Equally found in males and females

Watch this video of a girl with a phobia for pickles.

Panic Disorder &

Agoraphobia

Panic Disorder• Panic attacks—sudden episode of helpless terror

with high physiological arousal that can last for a few minutes to a few hours.

• Symptoms include – intense fear, shortness of breath, dizziness, rapid heart rate, trembling, sweating, choking & nausea.

• Very frightening—sufferers live in fear of having them. Feel like they’re dying.

• Agoraphobia often develops as a result

Agoraphobia

• Fear of situations the person views as difficult to escape from

• Causes person a fear of leaving one’s home or room in the house

• 50-80% of phobics are this.

Cognitive-Behavioral Theory of Panic Disorder

• Sufferers tend to misinterpret the physical signs of arousal as catastrophic and dangerous

• This interpretation leads to further physical arousal, tending toward a vicious cycle

• After their first panic attack, they become even more attuned to physical changes, increasing the likelihood of future panic attacks

Generalized Anxiety Disorder

Generalized Anxiety Disorder (GAD)

• More or less constant worry about many issues

• Lasts for more than 6 months.

• The worry seriously interferes with functioning

• Physical symptoms– headaches

– stomach aches

– muscle tension

– irritability

Are Your Worries Excessive?

• Add up your TOTAL Score• 0-11 points = You are not the fretful type. Worry,

which no doubt makes you uncomfortable, goads you to take necessary action in your life.

• 12-20 points = You’re a potentially unhealthy worrier.

• 21-30 points = Danger zone! Agonizing constantly about small matters isn’t good for you physically or emotionally.

Obsessive-Compulsive Disorder

Obsessive-Compulsive Disorder (OCD)• An anxiety disorder characterized by unwanted, repetitive

thoughts and actions

• The obsessions/compulsions begin to take control of the person’s life.

• Obsessions—irrational, disturbing thoughts that intrude into consciousness

• Compulsions—repetitive actions performed to alleviate obsessions & anxiety

– Overt physical behaviors, such as repeatedly checking or washing your hands

– Covert mental behaviors, such as counting or reciting certain phrases to yourself

Finding Your OCD Score• Circle the following item numbers if you marked TRUE

for them: 1, 2, 4, 6, 7, 8, 16, 17, 21• Circle the following item numbers if you marked FALSE

for them: 5, 9, 10, 11, 12, 13, 14, 19, 20, 22• Now add up your total score. Highest score possible is a

20 (items 3 & 15 are validity checks)• The mean (average) score is 11.15 for males and 11.24 for

females.• Remember, even if you scored high on this scale it doesn’t

mean you have OCD. Always ask yourself, “Do these tendencies I have disrupt my daily life and relationships?” If the answer is NO you don’t have a problem.

Trichotillomannia: The Disease of Hair Pulling

• What it’s like to live with it – video

• Trich – An explanation – video

Other Obsessions…

• Obsessive Texting - video

Posttraumatic Stress Disorder

PTSD

Posttraumatic Stress Disorder (PTSD)

• Follows events that produce intense horror or helplessness (traumatic episodes)

• Core symptoms include:– Flashbacks– Nightmares or unwelcomed thoughts– Numbness of Feelings– Avoidance of things that trigger memory– Sleep disturbances– Drug Abuse – Alcoholism to deaden memories.

• There is a high correlation of suicide and drug abuse in PTSD – See news report on Military Suicides in Soldiers fighting in Iraq – 2 min.

Causes of Anxiety Disorders

Psychological Causes• Psychoanalytic – forbidden childhood urges that have been

repressed result in anxiety.– If they do emerge it may be in the form of a compulsion (hand

washing).

• Learning Theorists – People learn to reduce anxiety by avoiding the situation (neg. reinforcement). Can’t get better because they don’t face it. – Phobias are classically conditioned in childhood. Traumatic event

or seeing someone else experience it causes our fears of that object.

• Cognitive - People make themselves anxious by responding negatively to most situations and coming to believe they are helpless to control what happens to them increasing their anxiety.

Biological Factors• Hereditary factors may result in a predisposition for

developing anxiety disorders• Brain functions appear to be different in an anxiety

disorder patient• Twin Studies – If one identical has it then 45% of the

time the other had it even when raised apart. If fraternal twins it drops to 15%.

• Adoption Studies – adopted children more likely to have anxiety disorder if birth parents have it.

• Evolutionary Theory – Those that could develop fears quickly often survived better.

Interaction of Biological & Psychological Factors

• Person may be biologically predisposed to overreact to physical symptoms of panic (shallow breathing & fast heartbeat) causing them to react with more fear increasing their panic.

• Anxiety about having another panic attack become a disorder itself.

Behavioral (Learning) Causes of Phobias

• Classical conditioning may be involved in the development of a specific phobia that can be traced back to some sort of traumatic event. – People with phobias may have

developed a conditioned response of fear to a conditioned stimulus

– Problems with this theory: • often no memory of a traumatic experience• traumatic experience may not produce phobia

Other Learning Factors• Observational learning--watching another

experiencing fearfulness--may result in developing fear.

• Operant Conditioning - Fear of an object may be negatively reinforced when by avoiding the feared objects.